Provider Demographics
NPI:1194808824
Name:BURNS, JOAN W (PHD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:W
Last Name:BURNS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 BEACON PKWY W
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-3124
Mailing Address - Country:US
Mailing Address - Phone:205-912-2000
Mailing Address - Fax:205-945-1890
Practice Address - Street 1:631 BEACON PKWY W
Practice Address - Street 2:SUITE 203
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3124
Practice Address - Country:US
Practice Address - Phone:205-912-2000
Practice Address - Fax:205-945-1890
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALR75652Medicare UPIN